Caring for Childen and Families in the Community: Children's Hospital Community Services Report, 1995 -1996

24 Pages·1996·1.6 MB·English

by  Children's Hospital (Boston, Mass.)

Caring for Children and Families
Children's Hospital
Community Services
Report Children'sHospital
TABLE OF CONTENTS
Message from the Chairman and President
A Partnership with the Community
The Status ofChildren Today
New Partnershipsfor Prevention
Caring forChildren and FamiliesToday
Shaping a Healthy Future forChildren
In Conclusion
PresidentandChiefExecutivt Officer: DavidS. Wi
ChairmanoftheBoardqj Trustees: GEORGi H.Kidder
PublishedbytheCommunis Benefits(Mli.i
VicePresidentfoi NetworkDevelopmentand
CommunityServices: DlBORAHi | ion
iijreitoi <•!i ommunit) Bim(its I
Editoi I II UETHH V DREWS
Caring for Children and Families in the Community
DavidS.Weiner,left,
andGeorgeN.Kidder
BostonCityHospital(BCH)havemergedtheir
pediatricresidencyprogramsandarecollaborat-
ingonthedevelopmentofanurbansystemof
pediatriccare.
Today,morethanever,Children'sisaresource
andaleaderincaringforBoston'schildreninthe
faceofsocialstressesthatweighonurbanfami-
liesandchallengetheoverallhealthofchildren.
Fromitsprogramsdevotedtopreventing
n1869,thepeopleofBostonputtheirfaithinafledg- HIV/AIDS,leadpoisoning,infantmortality,andteenpregnancytoits
IlingventurecalledTheChildren'sHospital. Sinceits advocacyservicesforvictimsofdomesticviolence,therearemany
foundingasoneofthenation'sfirsthospitalsdedicated waysinwhichChildren'sprovidespreventiveeducationthatraises
tothehealthandwell-beingofchildren,Children'shas thegeneralstandardsofhealthforBoston'schildren.
remainedcommittedtoitsoriginalmission: toserve In1994,Children'sformalizeditscommitmenttothehealthneeds
thechildrenandfamiliesofBoston,insicknessandinhealth. Tobe ofthelocalcommunitywiththeinaugurationoftheCommunity
sure,Children'shaschangedoverthelast127years. Oncea20-bed BenefitsProgram. Thisreporthighlightsthehospital'sefforts,bothold
hospitalinBoston'sSouthEnd,ithasgrownintoa325-bedmedical andnew,tohelpimprovethehealthofchildrenandtosupportthe
center,hometoaworldrenownedresearchcenterandnotedasone well-beingoffamilies. Itisourhopeandthehopeofthemany
ofthetoptrainingcentersforthecaregiversoftomorrow'schildren. Children'sstaffonLongwoodAvenue,intheneighborhoodhealthcen-
Today,Children'scontinuestogrowaswebuildanintegratedsystem ters,andinthecommunitythattheseeffortscanbringaboutabetter
ofcare,fromprimaryandpreventivecaretohospitalandhomecare qualityoflifeforourcity'schildren.
—
services manybasedinourcity'sneighborhoodsandsurrounding
communities. Throughoutthistimeofchange,Children'shas
remainedaccessibletoanychild,nearorfar,inneedofhelp.
AsChildren'svisionofabroadercaredeliverysystemgrows,the
hospitalhasnotlostsightofthecommunitywhereitbeganandits DAVIDS.Weiner,PresidentandChiefExecutiveOfficer
surroundingurbanneighbors. Wecelebratethe30thanniversarythis
yearofMarthaEliotHealthCenterinJamaicaPlain,Children'scom-
munityresourcethatoffersfamily-centeredprimaryandspecialty
care,aswellasoutreacheffortsrelatedtoprenatalcare,immuniza-
tions,substanceabuse,andHIV/AIDS. Thisyear.Children'sand GeorgeH.Kidder,ChairmanoftheBoardofTrustees
A Partnership with the Community
DeborahC.Jackson,left,
andCarolynJ.Singleton
hildren'shashadalonganddistinguishedhistoryof
commitmenttothechildrenofBostonthroughoutits127
C yearsofservice,demonstratedinthemanyprimarycare,
outreach,andadvocacyprogramsdevelopedherethat
serveasmodelsforprogramsacrossthecountry. Butby
1994,itbecameclearthatdeclininggovernmentsupportforthegrow-
ingpublichealthandsocialneedsofthecity'schildrencalledfora
greatercommitmentfromChildren'sHospital.
FromtheBoardofTrustees'reaffirmationofChildren'scommitment
tothecommunityemergedagroundswellofsupportforaCommunity
BenefitsProgramthathadalreadybeguntheenormoustaskofsurvey-
inginternalandexternalhospitalandhealthcenterprogramsthatpro-
videessential,high-qualityservicesandthatcouldbeafocusof
Children'sefforts. Inputfromthecommunityitselfwasessentialto
theprocess,andin1995theCommunityBenefitsAdvisoryBoard,
comprisedofstafffromChildren's,MarthaEliotHealthCenter,the
hospital'sBoardofOverseers,communityrepresentatives,andcommu-
nityresidents,wasestablished. Theadvisoryboard'schargewasto
ThisreportdescribestheCommunityPartnershipProgramandthe
developaprocesstoaugment,support,andinconcertwiththecom-
manycommunityhealthinitiativesthathaveprovidedafoundation
munity,developcommunityhealthinitiatives. Thetargetcommunity
forthisinitiativewasdefinedaschildrenandadolescentslivingin andaframeworkonwhichtobuildit. Inpartneringwithcommunity
organizationsandwiththecommitmentandguidanceofthe
povertyinthecityofBoston.
CommunityPartnershipAdvisoryBoard,thisinitiativetakesona
ThefirststepoftheCommunityBenefitsProgramwastoperforman
centralroleinChildren'smissiontoimprovethehealthofchildren.
assessmentofthehealthstatusandneedsofBoston'schildrenand
youth. Theneedsassessmentrevealednumerousareasinneedof
intervention,includingthreecriticalareaswhereChildren'sefforts /L^^v^^W^m
couldhavethemostimpact:1)injuryprevention;2)violenceprevention
andyouthdevelopment;and3)preventionofsubstanceabuseand
HIV/AIDS. Threesubcommitteesoftheadvisoryboardwereformedto DeborahC.jackson, Vwe-Prcsidcnt[orNetworkDevelopment
andCommunityServices
developstrategiesinpartnershipwithcommunity-basedorganizations
toaddresstheseissues. TheirworkistheCommunityPartnership
Program.
CarolynJ.Singleton, Directoi qj ( ommunit) Benefits
The Status of Children Today
Every32secondsababyisbomintopovertyintheU.S.
Morethan25percentofBoston'schildrenliveinpoverty. InsomeBostonneighborhoods,nearly
50percentofchildrenliveinpoverty. Povertyaffectschildrenofallracesandethnicgroopsbut
disproportionatelyaffectsblackandLatinochildren.
Childrenandadolescentsfromlow-incomefamiliesinBostonarenearlytwiceaslikelytodieasa
resultofhomicideaschildrenandadolescentsfrommiddle-orhigh-incomefamilies.
HomicideisthetwelfthleadingcauseofdeathintheU.S.,thesecondleadingcauseofdeathfor
adolescents,andtheleadingcauseofdeathforblackmalesandfemales15to34yearsold.
Every2hoursachildiskilledbyafirearmintheU.S.
Every4hoursachildcommitssuicideintheU.S.
Every10secondsachildisreportedabusedorneglectedintheUS. Every5hoursachilddies
fromabuseorneglect.
Nationally,injuriesaretheleadingcauseofdeathanddisabilityforchildren. Thereare
morethan7,000injury-relatedchilddeathsintheU.S.everyyear,andmorethan
30,000childrenarepermanentlydisabledduetoinjuries. Someoftheleadingcauses The mission ofthe
CommunityPartnership
ofunintentionalinjuriestochildrenaremotorvehicleaccidents,bicycle-relatedinjuries,
Program istoworkin
andfallsfromunsecuredwindows.
partnershipwith
Nationally,blacksare5to 15timesmorelikelythanwhitestohaveachildinfectedwith thecommunityto devise
HIV. HIV-infectedchildreninMassachusettsaredisproportionatelychildrenofcolor. and implementinitiatives
thatprotectand improve
InMassachusetts,2outof1,000livebirthsin 1994weretoHIV-positivemothers.
the health ofchildren and
adolescentswhilesupport-
ingandstrengthening
thewell-being offamilies
and communities.
New
Partnerships for Prevention
ThethreetargetareasthattheCommunityPartnershipProgramhas identifiedasprioritiesthisyearareinjury
prevention,violencepreventionandyouthdevelopment,and preventionofsubstanceabuseand HIV/AIDS. Guided
bytheCommunityPartnershipAdvisoryBoardsubcommittees, Children'sisworkinghand-in-handwiththe
communitytoaddressconditionsthatleadtotheseandotherproblems.
InjuryPrevention distributededucationalmaterialsto
SubcommitteeCo-Chairs families,aneffortwhichdramatically
JosephM.Carrillo,M.O., reducedchildren'sfallsfromwindows.
executivedirectorof In1994and 1995,therewasan83per-
MarthaEliotHealth centdecreaseinthenumberofchildren
Center,andJoan hospitalizedwithinjuriesandnoreport-
Wceosmtmburnoiotky,hCehailltdhrenl'iasison edfatalitiesasaresultofwindowfalls.
Buildingonthesuccessofthiscollab-
forHealthyConnections
oration,theCommunityPartnership
Program'sInjuryPreventionSubcommittee
hasbroughttogetherrepresentatives
fromadiversesetoforganizationswith
acommonconcernandobjective-
thereductionofchildhoodinjuries.
Subcommitteemembersincluderepre-
sentativesfromBromley-HeathTenant
Injuryprevention ManagementCorporation(TMC),Project
E njuriesaretheleading Life,CIPP,andSouthCoveYMCA. The
causeofdeathanddisabili- initialinjurypreventioninitiativeisacar
II tyforchildren. Themost seatprogram. Thegoalofthisprogram
frequentcausesofuninten- istoreducethenumberofinjuriesto
tionalinjuryincludemotor childrenduetolackofchildpassenger
Educatingpeople vehicleaccidents,acciden- restraints. Theprogramstrategyisto:
aboutinjurypreventionis talshootings,falls,poisoning,burns, •workwithcommunitypartnersinthe
drowning,choking,andsuffocation. developmentandimplementationof
whereitallstarts...Most Thesearefactsthatcanbechanged.
thisinitiative;
familiesdon'tknowthey Manyoftheseinjuriescanbeprevented.
In1993,Children'sparticipatedina • educatefamiliesontheimportanceof
maybecontributingtoan citywideinitiativetoinstallwindow carseats,safetydevices,andtheir
unsafeenvironmentfor guardsonupper-storywindowsinthe properusethroughtheuseofcultural-
homesofchildrenunder6inBoston lyrelevanteducationmaterialsand
theirchildren. neighborhoods. Incollaborationwith outreachefforts;
JoanWestbrook theBostonChildhoodInjuryPrevention • increaseaccessibilityofinfantandtod-
Children'scommunity Program(CIPP),BostonHousing dlercarseatstofamiliesinneed;and
healthliaisonforHealthy
Connections Authority(BHA),andtwoHealthy • developmeasurestoevaluatetheeffec-
BostonCoalitions,the KidsCan't Fly tivenessoftheprogram.
Programinstalledwindowguardsand
"Educatingpeopleaboutinjurypre-
ventioniswhereitallstarts,"saysJoan
Westbrook,Children'scommunityhealth
liaisonforHealthyConnections(see SubstanceAbuseandHIV/AIDS
page8)andsubcommitteeco-chairwith PreventionSubcommittee
JosephM. Carrillo,M.D.,executive Co-CbairsJuliaOjeda,executive
directorofMarthaEliotHealthCenter. directorofSociedadlatina,Inc.
"Mostfamiliesdon'tknowtheymaybe andDurrellFox,Children'sout-
reachandservicecoordinatorfor
contributingtoanunsafeenvironment BostonHAPPENS
fortheirchildren. Forexample,auto
safetyinvolvesmorethanowningacar
seat;itrequiresusingtheseatproperly. beenselectedaspotentialrespondentsto
Andparentswhodon'townacarstill atelephonesurveyaboutthetypesof
shouldhaveacarseatonhandtouse substanceabuseinterventionservices
whentheirchildridesinothervehicles. andsupportgroupsavailabletochildren
We'recollaboratingwithcommunity andadolescentsinthecommunity. The
groupstoofferworkshopsonwaysto purposeofthesurveyistogatherdata
preventawiderangeofinjuries. This ongapsinservicesinsubstanceabuse
isanareawherewecanreallymakea preventionandinterventioninitiatives.
difference." Thisyear,thesubcommitteewillfocus ...Historically,healthcare
Westbrookhasalreadybegunthetask itseffortsonpreventingsubstanceabuse, providershavetendedtolookat
ofcoordinatingthetrainingofstaffwho predicatedonthebeliefthatacorrelative
willserveashealthadvocatesinhousing decreaseintheincidenceofHIV/AIDSin problemsandwanttofixthem;our
developments. Thesemothersand thecommunitywillfollow. subcommitteeisworkingwith
ginrgantdhmeowtohredrsownilalvbaeritethyeokfehyeatlotsh-prreelaadt-- SoJcuileidaadOjLeadtai,nae,xeInccu.t,ivwehdoirceoc-tcohraiorfsthe Children'sandotherprovidersto
edtopicsatconvenientlylocatedhealth subcommitteewithDurrellFox, shifttheirfocustoward
stationsinthehousingdevelopments. Children'soutreachcoordinatorfor prevention.
BostonHAPPENS(seepagell),says,
Substanceabuseand "OurcommitteeishelpingChildren's JuliaOjeda
HIV/AIDSprevention workwithdiversegroupsinthecommu- eSxoecciuetdiavdeLdaitriencat,orInocf.
nitytoincreaseprimarypreventionina
TheSubstanceAbuseandHIV/AIDS
culturallycompetentway. Historically,
PreventionSubcommitteeisworkingto healthcareprovidershavetendedtolook
dpervoeblloepmsintihtaiattiavfefsectthaatnminacyrehaeslipngpnreuvme-nt astubpcroombmlietmtseaenidswwaonrtkitnogfwixitthheCmh;ilodurern's
berofchildrenandfamilies. Inconjunc-
andotherproviderstoshifttheirfocus
tionwithcommunityagencies,commu-
towardprevention."
nitycenters,andneighborhoodhealth
centers,thesubcommitteewillutilize
Violenceprevention
existingprimaryinterventionmodelsin
andyouthdevelopment
itseffortstopreventsubstanceabuse,a
leadingcauseofthetransmissionofHIV, Morechildrenandfamiliesareaffect-
amongwomenofchildbearingage. edbyviolencetodaythaneverbefore,
Apoolofcommunityagencieshas andChildren'sbelievesrespondingto
theirneedsisapriority. Accordingto
AlissaRobinson,aMissionHillresident
andco-chairoftheViolencePrevention
RonaldB.White,M.D.,M.Div.,
medicalconsultanttoProject
NewLife-Bromley-Heath,left, Weheldafocusgroupwithmem-
andAdamRice,U.C.S.W.,director
bersofthenommunitytolookatthe
programsalreadyinplaceandwe're
makingrecommendationsabout
whereChildren'scancontribute.
AlissaRobinson
MissionHillresident
Thefocusgroupbroughttogethermore
than40communityparticipants,includ-
ingrepresentativesfromtheBoston
PoliceDepartment,TeensAgainstGang
ProjectNewLife-Bromley- ManagementCorporationto Violence,FenwayCommunity
Heathisacommunity-based, providemedical,psychologi- DevelopmentCorporation,Sociedad
daytreatmentprogramforsub- cal,andsocialservicesto Latina,Inc.,RoxburyComprehensive
stanceabusersinBromley- abusersofalcoholand/or HealthCenter,Bromley-HeathTenant
Heath,thepublichousing drugs. ProjectNewLifeser- ManagementCorporation,YouthOnly
complexwhereMarthaEliot vicesareavailabletoall AIDSLine,theUrbanLeague,Mission
wHpbrieyotaMjlheatcthrthteCwheaBanrtsEoelmfrilootieusyni-lndoHepcedaaartittenhnd.e1Tr9esT9nh4haienpt Baspurrsebopgsmentlcaaeinnyatcl-eHaeenfaafdbot/urhostrermraeassd.diodeleentstocse,ennwrtioltlh HoirlgTlahnCeiozfamtomicuounnssigtarynoduCpeinnwtdaeisrviscd,uoaanlndsdu.cottehderasa
communitymappingexercisedesigned
toidentifycommunityassetsandgapsin
andYouthDevelopmentSubcommittee, ommendationsaboutwhereChildren's
thesubcommittee'sfirstchallengewasto cancontribute."
comeupwithadefinitionofviolence. Thefirststepintheprocessofascer-
"Domesticviolenceandgangviolence tainingwhereChildren'ssupportwould
areobvious,butwewantedtoinclude bemostbeneficialwastoidentifythe
moresubtleformsofviolencethatare needsinthecommunity. Thesubcom-
equallyharmful,suchasviolencethat mitteedeterminedthatafocusgroup
occursonadate,"saysRobinson. "We wouldprovidethemostinformative
heldafocusgroupwithmembersofthe forumforanalyzingthiscomplexissue.
communitytolookattheprograms SubcommitteeCo-ChairRobertLewisJr. ViolencePreventionandYouth
alreadyinplaceandwe'remakingrec- hostedthesessionatCityYearBoston, DevelopmentSubcommittee
whereheservesasexecutivedirector. Co-ChairsRobertLewisJr.,
executivedirectorolCityYear
Boston,andAlissaRobinson,
MissionHillresident
HaroldSparrow,executivedirectorof
toeRoxburyYMCA,facilitatesagroup
discussionataviolenceprevention
focusgroupwiththeassistanceof
JuliaOjeda.
The CommunityPartnership
Program currentlysupports
a collaboration between
violencepreventionservices. Overall,it ExecutiveOfficerDavidS.Weiner Boston LatinSchooland
wasperceivedthatthemostvaluable chairedtheDomesticViolenceTaskForce Children's inwhichstaff
communityassetsaretheexistingcom- oftheConferenceofBostonTeaching psychologistsworkwith
munityorganizations,churches,health Hospitals(COBTH)(seepage 14).
andmedicalservices,andyouthpro- TheViolencePreventionandYouth faculty,students,and
gramsdeliveringservicesandproviding DevelopmentSubcommitteewilllinkits parents in asuicide
supporttochildrenandfamilies. The effortswiththeCOBTHtaskforceand prevention programat
needforincreasedcoordination,collabo- otherongoingprogramsatthehospitalto
the highschool.
ration,andcommunicationamongpro- combatthisescalatingproblem.
gramsandorganizations,andforan
increaseininformationandeducation
providedtothecommunityemergedas
gapsrequiringurgentattention. Inaddi-
tion,therewasarecognizedneedfor
moreprogramstosupportyouthduring
the"latch-key"hours. Thiscommunity
mapwillnowserveasthebasisforthe
nextphaseofthesubcommittee'sefforts:
thedevelopmentofinitiativesthatmaxi-
mizeexistingassetstofillthecriticalgaps.
Violenceoccursinthehomeaswellas
onthestreets,andthroughanumberof
Ten-year-oldAddisParris,right,
initiativesatChildren's,theissueof
notestheimportanceofthethree
domesticviolencepreventionhasgained
Cs,"cooperation,coordination,
substantialsupportandattention. Most
andcollaboration."ataviolence
recently,Children'sPresidentandChief preventionfocusgroupheldat
CityYearBoston. Sheispictured
withhermother,CarolBrayboy.
Caring for Children and Families Today
Children'shasawiderangeoflong-established programsdedicatedtoimprovingthehealthandwell-beingofthe
childreninitssurroundingneighborhoodsandthroughoutthecityofBoston. In 1996,thehospitalwill provideprimary
careandcoordinationofspecialtycaretomorethan35,000childrenthroughPediatricHealthAssociates,anewser-
vicecreatedbythemergerofCCHP(ComprehensiveChildHealthProgram)andPGA(PediatricGroupAssociates),and
throughtheGrowthandNutrition, LeadandToxicology,andYoungParentsprograms. Aseconomicandsocialcondi-
tionshavechangedoverthe lastdecades,communityoutreachefforts,school-basedprograms,andsocialservicesup-
portshavebeenestablishedtoaddresstheneedsofunderservedchildrenandfamilies. And intheongoinghealth
caredebate,Children'sisastrongandunwaveringvoiceinsupportofaccesstohealthcareforallchildren.
MarthaEliotHealthCenter: receiveWICnutritionsupportservices.
Thirtyyearsofservingfamilies AccordingtoMildredHailey,executive
arthaEliotHealthCenter,a directoroftheBromley-HealthTenant
communityhealthcenter ManagementCorporation(TMC)and
M operatedbyChildren's vice-chairofMarthaEliot'sCommunity
Hospital,hasbeenacor- AdvisoryBoard,thenewhealthcenter
nerstoneofChildren'scom- andthenewStop&Shopsupermarket
MildredHailey.executive munityprogramsfor30 openingnextdoorrepresentarealturn-
dHieraetchtoTreonfanttheMaBrnoamgleemye-nt years. LocatedintheBromley-Heath aroundfortheBromley-Heatharea.
Corporation,andJosephM. housingdevelopment,MarthaEliot "Children'sismakingasignificantinvest-
Garrillo,M.D. offerscomprehensive,family-centered mentinthisneighborhoodanditspeo-
primaryhealthcareandsomespecialty ple,"saysHailey. "Thecollaboration
&
servicesforchildren,adolescents,and betweenthecity,Children's,Stop
adults. Thecenteralsoprovidesawide Shop,andTMChasbeenaverypositive
rangeofoutreachservicesincluding forceforthisneighborhood. Thisisa
earlyprenatalandwell-babycare;sub- giantsteptowardimprovingthequality
stanceabusepreventionandtreatment; oflifeinBromley-Heath."
HIVeducation,counseling,andtesting;
andmedicalcareforpeoplewith HealthyConnections:
HIV/AIDS. Morethan48,000patient Giving infantsahealthystart
visitsarerecordedannually. AcollaborativeinitiativeofChildren's,
Thisyear,MarthaEliotopensthe BethIsrael,andBrighamandWomen's
doorstoitsnewstate-of-the-artfacility. hospitals,HealthyConnectionswas
Thecenter,designedtomeetthegrow- developedtoimprove infanthealthand
inghealthandsocialneedsoftheresi- well-beinginBostonneighborhoodsthat
dentsofBromley-Heath,JamaicaPlain, havehighratesofinfantmortality.
andRoxbury,offerslargerclinicalareas, Launchedin 1992,HealthyConnections
aseparateadolescentclinic,andadjacent servesmotherswhodelivertheirbabies
pediatricandmaternalhealthclinical atBethIsraelorBrighamandWomen's
areas. ItalsoincludesspaceforaWIC andreceive pediatriccareat Children'sor
(Women, Infants,andChildren)office,
makingiteasierforfamiliestoenrolland